[Objective] To explore the activity aberration of primary insomnia (PI) patients with resting-state fMRI.[Methods]Resting-state fMRI datasets of 60 PI and 60 healthy controls were acquired.We investigated the cortical connectivity patterns of the insula in PI and independent-sample t-test were used to compare the brain activity abnormalities between two groups.[Results] In PI,we found enhanced connectivity between left insular with the left middle cingulate cortex,the Frontal_Sup_Media and right Parietal_Inf,as well as decreased connectivity with the left precentral gyrusand the right fusiformgyrus (P ＜ 0.05).The right insular show increased FC with the right middle cingulate cortex,the right fusiform gyrus and the right middle frontal gyrus,as well as decreased FC with the right precentral gyrus and the right middle temporal gyrus (P ＜ 0.05).[Conclusion] This study provides additional evidence of brain functional integration alterations in PI.Those may help us understand the possible neural mechanisms of PI.

Objective To analyze radiation induced alterations of vitronectin and collagen expressions in fibroblasts at different times post-irradiation,so as to evaluate the potential to apply vitronectin as a biomarker of radiation-induced lung fibrosis.Methods The human fibroblast cells WI-38 and IMR-90 were irradiated with 137Cs γ-rays at doses of 0 (control),4,6,8,10 and 12 Gy,respectively.The cells and its supernatant were collected at 6,12,24,36,48 and 60 h post-irradiation.The expressions of vitronectin and collagen Ⅰ and Ⅲ were analyzed by Western blot,PCR and ELISA.Results After irradiation,the expressions of vitronectin and collagen Ⅰ and Ⅲ were positively correlated (r=0.40-0.79,P＜0.05) and were all significantly higher than that in control group (t =3.04-25.45,P ＜0.05) and reached the highest expression levels at 48 h after 8-10 Gy of irradiation (t =2.92-18.86,P ＜ 0.05).Analyses of Real-time PCR and ELISA assay showed that expressions of vitronectin mRNA and its protein level in the cell lysis were significantly increased by radiation (F =27.09-42.62,P ＜ 0.05).Conclusions The expressions of vitronectin in cellular supernatant and its mRNA may be a potential biomarker of radiation-induced fibrosis,and 48 h after 8 Gy irradiation may be an optimum condition of measurement.

Objective:To review the experience of closure of the left-main-bronchial stump fistula using endoscopic liner cutter staplers through the right thoracic approach and I stage or staged treatment for the left pyothorax.Methods:6 patients with the left-main-bronchial stump fistula after left pneumonectomy combined with pyothorax were treated by closing the left-main-bronchial stump using endoscopic liner cutter staplers through the right thoracic approach, and pleura was used to cover the distal and proximal incisional margin of the stump respectively. The thoracic T-tube drainage was used in the I stage or staged treatment for the left pyothorax.Results:All patients were survived without recurrence of the bronchopleural fistula. 4 patients were observed to have no recurrence of pyothorax when 1 patient had recurrence of pyothorax and was treated with intermittent T-tube drainage.1 patient operated with left-thoracic fenestration in the past was treated with drainage waiting for secondary operation.Conclusion:The right thoracic approach seemed to be a safer and more effective method than the transsternal transpericardial approach in cases with the left-main-bronchial stump fistula combined with pyothorax. The use of endoscopic liner cutter staplers reduced the risk of bleeding, infection and recurrence of fistula. The T-tube drainage in the I stage or staged treatment for the left pyothorax was considered to be an easier way for treatment.

As the main weapon of cellular immunity,CD4+ T cells play a vital role in controlling and eliminating infections,and are an important barrier for the body to resist infections.Respiratory tract infectious diseases caused by influenza virus infection have extremely high infectivity,morbidity and mortality.The infection mechanism is relatively complicated and has not been fully ex-plained.The exuberant immune response induced by the body after influenza virus infection is described as a"cytokine storm"which is related to pro-inflammatory cytokines and tissue damage,which may eventually lead to acute lung injury.Therefore,this article sum-marizes the current research progress,focusing on the mechanism of CD4+T cells in the cytokine storm induced by influenza virus in-fection and the impact of acute lung injury,providing relevant ideas and theoretical guidance for follow-up research,with a view to the disease caused by influenza virus bring new and effective methods of diagnosis and treatment.

Atherosclerosis is a complex and multi-factorial pathophysiological process. Researches over the past decades have shown that the development of atherosclerotic vulnerable plaque is closely related to its components, morphology, and stress status. Biomechanical models have been developed by combining with medical imaging, biological experiments, and mechanical analysis, to study and analyze the biomechanical factors related to plaque vulnerability. Numerical simulation could quantify the dynamic changes of the microenvironment within the plaque, providing a method to represent the distribution of cellular and acellular components within the plaque microenvironment and to explore the interaction of lipid deposition, inflammation, angiogenesis, and other processes. Studying the pathological mechanism of plaque development would improve our understanding of cardiovascular disease and assist non-invasive inspection and early diagnosis of vulnerable plaques. The biomechanical models and numerical methods may serve as a theoretical support for designing and optimizing treatment strategies for vulnerable atherosclerosis.
Atherosclerosis ; Biomechanical Phenomena ; Computer Simulation ; Humans ; Inflammation ; Models, Cardiovascular ; Plaque, Atherosclerotic/diagnostic imaging*

Urine is produced from the urinary system, and urinary cell-free DNA (cfDNA) carries genomic DNA directly secreted from urinary system.Urine samples are non-invasive, unlimited in quantity and easy to obtain, making urinary cfDNA a promising biomarker for urologic diseases.This article reviews the progress of clinical application of urinary cfDNA in urologic diseases.

OBJECTIVE To investigate the eff ects of hypoalbuminemia and human albumin supplementation on patients with acute kidney injury （AKI）after off-pump coronary artery bypass grafting （OPCABG）. METHODS From December 2018 to January 2020，clinical information of 484 patients with coronary atherosclerotic heart disease who underwent selective OPCABG in Tianjin Chest Hospital were analyzed retrospectively. The basic data ，American Society of Anesthesiologists （ASA）grading，the number of coronary artery bypass grafting ，amount of intraoperative bleeding ，use of artificial colloid ，minimum value of hemoglobin within 7 days after operation ，hypoalbuminemia occurred after operation ，monitoring time in postoperative intensive care unit ，drainage volume of thoracic catheterization ，perioperative blood transfusion ，amount of human albumin after operation were summarized. All patients were divided into non-AKI group （414 cases）and AKI group （70 cases）according to the occurrence of AKI. The differences of the above indexes between the two groups were compared. Multiple Logistic regression analysis was performed to analyze the risk factor of AKI when selecting the indexes with P＜0.1. According to whether hypoalbuminemia occurred after operation ，all patients were divided into normal protein group （347 cases）and hypoalbuminemia group （137 cases）. Hierarchical analysis was carried out to explore the correlation between human albumin supplementation and AKI. RESULTS The results of multiple Logistic regression analysis showed that there was no significant effect on AKI in postoperative hypoalbuminemia （P＞0.05），but there were significant effect in body mass index and the dosage of postoperative human serum albumin （P＜0.05）. The risk of AKI would increase by 12.7％ every time the body mass index increases by 1 unit；the risk of AKI increased by 17.3％ for every 10 g increase in the dosage of human albumin. Stratified analysis showed that the risk of AKI would increased by 26.9％ for every 10 g increase in postoperative human albumin supplementation in normal protein group and 14.0％ for every 10 g increase in postoperative human albumin supplementation in hypoalbuminemia group. CONCLUSIONS Hypoalbuminemia is not a risk factor fo r the development of AKI after OPCABG ，but human albumin supplementation is a risk factor for AKI after OPCABG.

Algorithms ; Crystallography, X-Ray ; Disulfides ; chemistry ; Models, Molecular ; Protein Conformation ; Proteins ; chemistry

OBJECTIVETo discuss the effect of electric coagulation through bronchoscopy in diagnosis and treatment of congenital vallecular cyst in children.

METHODTen cases of congenital vallecular cyst in the study with age ranged from 21 days to 4 years and 10 months were treated with electric coagulation through bronchoscopy. The therapeutic effect was evaluated by endoscopic and clinical manifestation. And all the patients were followed-up for 6-12 months.

RESULTAll the patients obtained 3-5 times electric coagulation. After the operation, the cyst decreased in size, epiglottis softening was subsided, uplift uncompression, dyspnea and laryngeal stridor were improved obviously. After follow-up periods of 6-12 months, no capsule wall were left, and the activity of the epiglottis resumed.No severe complication was found in any patient.

CONCLUSIONElectric coagulation through bronchoscopy is a simple, effective and safe method to treat congenital vallecular cyst in children.

Bronchoscopy ; methods ; Child, Preschool ; Cysts ; congenital ; diagnosis ; surgery ; Dyspnea ; etiology ; physiopathology ; Electrocoagulation ; Epiglottis ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Laryngeal Diseases ; congenital ; diagnosis ; surgery ; Male ; Respiratory Sounds ; etiology ; physiopathology ; Retrospective Studies ; Treatment Outcome